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RE <br />Laboratory and Radiation Services Division <br />• 8100 Lowry Boulevard, Denver CO 80230-6928 <br />US Mail: PO Box 17123, Denver CO 80217 <br />(303) 692-3090 fax (303) 3449989 <br />ronmcm fts <br />EST FOR ANALYTICAL SERVICES <br />System ID <br />Collection Date <br />Control Number <br />CUSTOMER <br />O l1 ?S Collected: s <br />+ Naune : Q) J mono, <br />INN-2008001915 <br />5/6`2008 1: 25: OOPM <br />20 <br />Address : )3 j h e,- yr an, s Collected by - , -`Mamx: <br /> <br />? am. <br />QLAIMI• <br />rj Contact:-Te v y Q 4 v r,/ a apko, k e-c?l &, W' Surface water <br />SAMPLE SITE COMMENTS <br />PWS ID. it Purpose : ? Routine [?4'e 1 Purpose ? Repeat <br />Sample Location: , M -A `rc <br />Description: I/`_ pt 1 - L,? CN l Uri Chlorine residual: ¦ ? F] MG/L Temp., Water: a ? F <br />Ji ! 1 <br />Address: ,l7 Comments: G L r C. - <br />j City: St zili- <br />: ? Ground water <br />Phone <br />? e-r ? Treated Water <br />cC <br />r <br />0 Lead ? yran?m ? Organic (SOC / VOC) ? Pseudomonas MPN <br />TEST ORDER (Che ck appropriate box) : (? <br />CHEMISTRY- INORGANIC CHEMISTRY- ORGANIC RADIOCHEMISTRY <br />? Alkalinity, Phenolphthalein ? lybdenum ? Carbamates ? Alpha/Beta, Gross <br />? Alkalinity, Total ?j-xicel ? VOC O Americium <br />Akuninum ? Nitrogen, Ammonia D'?st. p THM ? Carbon-14 <br />O Antimony ? Nitrogen, Kleldahl ? BTEX D Gamma Screen <br />[Arsenic ? 'Nitrogen, Total' ? DIQUAT , <br />O <br />c? <br />? Barium O N'drate/Nitrite O SOC Nuclide Specifi <br />? <br />? eeryniurrr ? Nitrkbe O SVOC l Test <br />? BOp ??{ ? Pesticides ? <br />P opium <br />? Boron D Phosphate, Ortho 6 <br />O Glyphosate ?, p Radium 226 <br />? Cadmium ? Phosphate, Total ? Herbiades ? Radium 228 <br />D Calcium p Potassium ? EDBIDBCP ? .Radon <br />? Chloride ? Selenium ? PCB O Thorium <br />C Chlorine, total residual <br />? Silicon (silicates) O TOC p Tritium <br />? Chromium D DRO ? Other. <br />v]?Condudiv?y O Silver ? HEM (Oil Grease) L-] Other. <br />(Copper ? Sodium ? O?r <br />? Corrosivity (?? tip) p solids, Dissonred ? other: MICROBIOLOGY <br />? Cyanide, Dist ? Solids, Suspended <br />? Fluoride ? Solids, Total <br />lf <br />t <br />S ? Total Col'ifonns, PA <br />MTF <br />lif <br />T <br />l C <br />t <br />u <br />a <br />e <br />O Hardness, total Phase 1,2,5 -ANALYSES onns, <br />o <br />a <br />o <br />D <br />?ron D Thallium ? Heterotrophic Plate Count <br /> <br />Magnesium Zinc <br />D ? Inorganic D E. Cog., MPN <br />/ <br />? <br />l1J nganese ? Other. O Other. <br />Mercury ? ocher: ?9AV09"CM€? Phi 5: other. <br />S,7f2-0? IOU <br />LABS Internet Address: http://www.cdphe.state.co.us/Ir/Irhom.htm <br />Report #250Req, Rev 1?A1/99 <br /> <br />